Ramblings of an Emergency Physician in Texas

U.S. nurses regularly face sexual harassment

U.S. nurses regularly face sexual harassment says the headline, and that’s probably true – somewhere in America, a few of us are going to get the offer for a kiss, a pinch on the bottom, or an offer for more intimate relations post discharge.

You need to go and read Alwyn’s experience with sexual harassment from a patient, it’s shocking!

And, this reminds me of one of those completely inexplicable things that happen in the ED, the patient who actively antagonizes their nurse.

It happens less often with docs, but it’s bizarre when I hear a patient start using four-letter words to the nurse who’s trying to be a pro and take care of them. I swear to you we need a ‘non-abuse’ exclusion from EMTALA so we can assist these people with the discharge from the ED they richly deserve.

Comments

My first couple weeks on my unit as an aide, I came on for report from the aide leaving. She tells me, “Watch out for the patient in 202, he’s a grabber.” “Grabber?” I say. “Yeah, you know, he flails about when you assist him out of bed and he conviently grabs your boob or butt.” Pretty common actually.
Needless to say I had a male nurse on the floor help me get him OOB that shift.

How PC! Why is it that the abuse we ALL endure from pt’s be first couched in sexual harrassment before it is recognized? Abuse is abuse. And we all endure far to much of it. In the good ole days the Er doc would himself/herself grap them by the collar and drag their butts outta there.

Hmmmmm….I’ve never been sexually harrassed…there were times as a young nurse that I encountered some verbal abuse by physicians (foul language, screaming); patients who did the same were usually intoxicated or had psych issues. Co-workers may have experienced it but I’ve never had one talk about it to me.

I don’t tolerate abuse of my nurses, racist comments directed at them, or most any other bad behavior (I’ve been called pretty much everything but a white man). While the old days of having security “take care of it” are probably gone, always remember that the pharmacy is mightier than the sword.

I find that simply shaming them works most of the time.

Some of the funniest ones are where other patients and other patients’ friends jump into the fight; those guys can be quite helpful. It’s amazing how many enemies a screaming drunk can make amongst patients/family/friends in neighboring beds…

“In the good ole days the Er doc would himself/herself grap them by the collar and drag their butts outta there.”

I remember those days. I remember jumping onto a drunks stretcher to pummel him after he grabbed a nurse by the hair and slammed her head against a wall. Now I call security, have the patient walked out, and all the way out the door he screams at me that he’s calling his lawyer tomorrow (or the Board of Medicine) to sue me or have my license revoked. In any other forum these people are arrested.

On a practical level, and for many reasons, you want to try to always handle this yourself. It starts with making sure the newly minted nurses understand they don’t need to put up with this, and to protect themselves and the other staff they need to let others know when it’s happening. Most of the time confronting the patient (verbally) is enough, making it clear what is not appropriate behavior. It’s a test of the head/supervisory nurse to take care of her staff in these situations. The next step for repeat offenders can be to let the family know what’s going on — the right kind of wife is better than the biggest security person you have.
Bringing in any outsiders can always have consequences you cannot control, and doesn’t unfortunately entirely release you from responsibility for what happens to the patient medically.

I should point out that sometimes fighting them is a bad idea; it’s wise to only fight if you’re out of other alternatives.

By way of example, A particularly memorable night of mine with an agitated 280lb veteran Navy SEAL. Even if we’d swarmed him, and I’d leapt onto his back with a syringe of sedatives, he probably could have crippled or incapacitated all of us before the drugs took him down.

Fortunately, one of my older security guys (who didn’t look like much at first glance) was a 5th group SF Vietnam veteran. After chatting for a few minutes, he had an almost immediate bond with the young Frogman, and we all got along fine after that.

I learned a lesson several years back from one of my “old and gray” former attendings. We had a 300 pound BAMF (Bad Ass Mother F’er) high on drugs, threatening to kill us all if we didn’t let him leave. With security standing there, 5 nurses, 5 residents, the attending let him walk out of the Emergency Department wearing just his underpants. Never saw him again. Bottom line, I know we are all worried about getting sued, but it’s not worth dying over. (And yes, we called the police, but they don’t help)